| Ld Behavioral And Support Services | |
|
50 W South Orange Ave South Orange NJ 07079-1730 | |
| (201) 486-3367 | |
| (973) 378-9525 |
| Full Name | Ld Behavioral And Support Services |
|---|---|
| Speciality | Psychologist - School |
| Location | 50 W South Orange Ave, South Orange, New Jersey |
| Authorized Official Name and Position | Edna Yolanda Lee (CEO/OWNER) |
| Authorized Official Contact | 2014863367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ld Behavioral And Support Services 382 Valley St South Orange NJ 07079-2806 Ph: (201) 486-3367 | Ld Behavioral And Support Services 50 W South Orange Ave South Orange NJ 07079-1730 Ph: (201) 486-3367 |
| NPI Number | 1184308793 |
|---|---|
| Provider Enumeration Date | 06/14/2023 |
| Last Update Date | 06/14/2023 |
| Certification Date | 06/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184308793 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103TS0200X | Psychologist - School | (* (Not Available)) | Primary |
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